Some people develop intestinal upset when taking andrographis. If this occurs, reduce the amount taken or take it with meals. Headache, fatigue, a bitter/metallic taste, and elevated liver enzymes were reported in one trial with HIV-infected people taking high doses of isolated andrographolides.37 This has not been reported in people using whole andrographis or standardized extracts at the recommended amounts. As with all bitter herbs, andrographis may aggravate ulcers and heartburn. The safety of andrographis during pregnancy and breast-feeding is unknown.